MEDICARE: DAVID L. BERRY, M.D. PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VM0101X	Maternal & Fetal Medicine Physician	J1499	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699885541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID L. BERRY, M.D. PA

Provider Business Mailing Address
First Line	:	6500 N MOPAC
Second Line	:	BUILDING 1, SUITE 1205
City	:	AUSTIN
State	:	TX
Zip	:	78731-3282
Country	:	US
Telephone Number	:	512-206-0101
Fax Number	:	512-206-0212

Provider Business Practice Location Address
First Line	:	6500 N MOPAC
Second Line	:	BUILDING 1, SUITE 1205
City	:	AUSTIN
State	:	TX
Zip	:	78731-3282
Country	:	US
Telephone Number	:	512-206-0101
Fax Number	:	512-206-0212

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MRS. VIRGINIA LYNN NUTT
Credential	:
Telephone Number	:	512-206-0101

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	06/29/2011

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